This MUST be a Master Level Paper with correct 7th edition APA format. The paper is based on two specific evidenced based practices for hypothyroidism that needs to be compare/contrast.
Choose 2 Evidence Based Practice (EBP) resources influencing the care provided to the patient.
See treatment note at bottom of page for details.
Discuss the similarities and differences that you read for those two ******Evidence Based Practice peer reviewed articles within last 2 years.
Submit scholarly paper, with writing style at the graduate level, including all of the following:
Reviews topic and explains rationale for its selection in the context of client care.
Evaluates key concepts related to Hypothyroidism.
Describes multiple viewpoints of management of Chronic Hypothyroidism (if this is a controversial issue or one for which there are no clear guidelines).—- It has to be either or!!!!
Assesses the merit of evidence found on this topic i.e. soundness of research again using Evidence Based Practice peer reviewed articles within last 2 years.
Evaluates current EBM guidelines, if available. Or recommends what these guidelines should be based on available research.
Discusses how the evidence did impact/would impact practice.
What should be done differently based on the knowledge gained?
Consider cultural, spiritual, and socioeconomic issues.
Hypothyroidism Follow-up
Description: Return visit to the Primary Care Clinic for hypothyroidism status post total thyroidectomy in 1992, and diabetes mellitus.
PROBLEM LIST:
1. Hypothyroidism.
3. Diabetes mellitus.
4. Insomnia with sleep apnea.
HISTORY OF PRESENT ILLNESS: This is a return visit for the patient with history as noted above. She is 42 years old African American female. Her last visit was 6 months ago. Since that time, the patient states her health has remained unchanged except for fatigue. Currently, primary complaint is one of fatigue that she feels throughout the day. She states, however, she is doing well with CPAP and wakes up feeling refreshed but tends to tire out later in the day. In terms of her thyroid issues, the patient states that she is not having signs or symptoms of thyroid excess or hypothyroidism. She is not reporting temperature intolerance, palpitations, muscle weakness, tremors, nausea, vomiting, constipation, or diarrhea. Her weight has been stable. She is not reporting proximal muscle weakness.
CURRENT MEDICATIONS:
1. Levothyroxine 125 micrograms p.o. once daily.
2. CPAP.
3. Glucotrol.
4. Metformin 1000 mg BID.
5. Synthroid.
REVIEW OF SYSTEMS: As stated in the HPI. She is not reporting polyuria, polydipsia or polyphagia. She is not reporting fevers, chills, sweats, visual acuity changes, nausea, vomiting, constipation or diarrhea. She is not having any lightheadedness, weakness, chest pain, shortness of breath, difficulty breathing, orthopnea or dyspnea on exertion.
PHYSICAL EXAMINATION:
GENERAL: She is an overweight, very pleasant woman, in no acute distress. VITAL SIGNS: Temperature 96.9, pulse 85, respirations not counted, blood pressure 135/65, and weight 85.7 kg. NECK: Reveals well healed surgical scar in the anteroinferior aspect of the neck. There is no palpable thyroid tissue noted on this examination today. There is no lymphadenopathy. THORAX: Reveals lungs that are clear, PA and lateral, without adventitious sounds. CARDIOVASCULAR: Demonstrated regular rate and rhythm. S1 and S2 without murmur. No S3, no S4 is auscultated. EXTREMITIES: Deep tendon reflexes 2+/4 without a delayed relaxation phase. No fine resting tremor of the outstretched upper extremity. SKIN, HAIR, AND NAILS: All are unremarkable.
LABORATORY DATABASE: Lab data on 01/01/22 showed the following: Thyroglobulin quantitative less than 0.5 and thyroglobulin antibody less than 20, free T4 1.35, and TSH suppressed at 0.121.
ASSESSMENT AND PLAN:
This is a 45-year-old woman with history as noted above.
1. Hypothyroidism, status post total thyroidectomy
2. Obtain a free T4, TSH, and thyroglobulin levels today.
3. Plan today is to repeat her thyroid function studies.
4. Taper her medication to get her TSH somewhere between 0.41 or less.
5. Follow up in 3 months or sooner.
This MUST be a Master Level Paper with correct 7th edition APA format. The paper
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